1.Value of the deep learning automated quantification of tumor-stroma ratio in predicting efficacy and prognosis of neoadjuvant therapy for breast cancer based on residual cancer burden grading
Ting XIE ; Aoling HUANG ; Lingyan XIANG ; Haochen XUE ; Zhengzhuo CHEN ; Aolong MA ; Honglin YAN ; Jingping YUAN
Chinese Journal of Pathology 2025;54(1):59-65
Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.
2.Value of the deep learning automated quantification of tumor-stroma ratio in predicting efficacy and prognosis of neoadjuvant therapy for breast cancer based on residual cancer burden grading
Ting XIE ; Aoling HUANG ; Lingyan XIANG ; Haochen XUE ; Zhengzhuo CHEN ; Aolong MA ; Honglin YAN ; Jingping YUAN
Chinese Journal of Pathology 2025;54(1):59-65
Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.
3.Comparison of fluorescence in situ hybridization(FISH)and urine cytology in diagnosing urothelial carcinoma:a single-center retrospective cohort study
Zhiting WANG ; Min REN ; Tian XUE ; Haochen WANG ; Heng CHANG ; Qianming BAI ; Xiaoyan ZHOU ; Xiaoli ZHU
China Oncology 2024;34(12):1080-1089
Background and purpose:Urothelial carcinoma(UC)is a prevalent malignant tumor of the urinary system,and early diagnosis is crucial for improving patient prognosis.This study evaluated the diagnostic efficacy of fluorescence in situ hybridization(FISH),urine cytology and their combination for UC,as well as for its different subtypes.Methods:This study included patients who underwent transurethral resection of bladder tumor(TURBT)from January 2022 to December 2023 and approved by Ethics Commetce of Fudan Univesity Shanghai Cancer Center,No.:050432-4-2307E)that met the inclusion and exclusion criteria.We collected TURBT pathological results and pre-procedure FISH and cytology results.Diagnostic accuracy,sensitivity and specificity of FISH,cytology and their combination were analyzed and compared for urothelial carcinoma.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist and Standards for Reporting of Diagnostic Accuracy(STARD)were followed for this study.Results:A total of 283 patients were enrolled in this study,136 were diagnosed with UC,and 147 were not.Of the 136 UC cases,79(58.09%)were invasive and 57(41.91%)were non-invasive.In terms of malignancy grade,112(82.35%)were high-grade UC and 24(17.65%)were low-grade UC.Using histopathology as the gold standard,the accuracy of FISH,cytology and their combination in diagnosing UC was 79.51%,72.08%and 77.39%,respectively;sensitivity was 72.06%,58.82%and 78.68%,respectively;specificity was 86.39%,84.35%and 76.19%,respectively.The area under the curve(AUC)for FISH and the combination was similar but higher than that for cytology(0.792 vs 0.716,P=0.006;0.774 vs 0.716,P=0.004);the Net Reclassification Improvement(NRI)for FISH compared to cytology was 15.28%(P=0.006).In the 79 cases of invasive UC,FISH had higher accuracy than cytology(86.28%vs 78.32%,P=0.011).The sensitivity of FISH and the combination was higher than that of cytology(86.08%vs 67.09%,P=0.004;91.14%vs 67.09%,P<0.001),and the AUC values were also higher(0.808 vs 0.713,P=0.004;0.784 vs 0.713,P=0.007).The NRI for FISH compared to cytology was 21.03%(P=0.003).In the 57 cases of non-invasive UC,the AUC values for all three methods were low(AUC<0.700).Among the 112 cases of high-grade UC,FISH had higher accuracy(84.94%vs 76.45%,P=0.005),and the combination had higher sensitivity(89.29%vs 66.07%,P<0.001)compared to cytology.The AUC values for FISH and the combination were also superior to that for cytology(0.847 vs 0.752,P=0.002;0.827 vs 0.752,P=0.001).The NRI for FISH compared to cytology was 19.01%(P=0.003).In the 24 cases of low-grade UC,the AUC values for all three methods were low(AUC<0.600).Conclusion:For UC,particularly invasive and high-grade subtypes,FISH shows superior diagnostic efficacy compared to cytology.FISH alone offers accuracy and sensitivity comparable to the combination test,with higher specificity.In cases of non-invasive or low-grade UC,however,all three diagnostic methods demonstrate relatively low efficacy.
4.Comparison of fluorescence in situ hybridization(FISH)and urine cytology in diagnosing urothelial carcinoma:a single-center retrospective cohort study
Zhiting WANG ; Min REN ; Tian XUE ; Haochen WANG ; Heng CHANG ; Qianming BAI ; Xiaoyan ZHOU ; Xiaoli ZHU
China Oncology 2024;34(12):1080-1089
Background and purpose:Urothelial carcinoma(UC)is a prevalent malignant tumor of the urinary system,and early diagnosis is crucial for improving patient prognosis.This study evaluated the diagnostic efficacy of fluorescence in situ hybridization(FISH),urine cytology and their combination for UC,as well as for its different subtypes.Methods:This study included patients who underwent transurethral resection of bladder tumor(TURBT)from January 2022 to December 2023 and approved by Ethics Commetce of Fudan Univesity Shanghai Cancer Center,No.:050432-4-2307E)that met the inclusion and exclusion criteria.We collected TURBT pathological results and pre-procedure FISH and cytology results.Diagnostic accuracy,sensitivity and specificity of FISH,cytology and their combination were analyzed and compared for urothelial carcinoma.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist and Standards for Reporting of Diagnostic Accuracy(STARD)were followed for this study.Results:A total of 283 patients were enrolled in this study,136 were diagnosed with UC,and 147 were not.Of the 136 UC cases,79(58.09%)were invasive and 57(41.91%)were non-invasive.In terms of malignancy grade,112(82.35%)were high-grade UC and 24(17.65%)were low-grade UC.Using histopathology as the gold standard,the accuracy of FISH,cytology and their combination in diagnosing UC was 79.51%,72.08%and 77.39%,respectively;sensitivity was 72.06%,58.82%and 78.68%,respectively;specificity was 86.39%,84.35%and 76.19%,respectively.The area under the curve(AUC)for FISH and the combination was similar but higher than that for cytology(0.792 vs 0.716,P=0.006;0.774 vs 0.716,P=0.004);the Net Reclassification Improvement(NRI)for FISH compared to cytology was 15.28%(P=0.006).In the 79 cases of invasive UC,FISH had higher accuracy than cytology(86.28%vs 78.32%,P=0.011).The sensitivity of FISH and the combination was higher than that of cytology(86.08%vs 67.09%,P=0.004;91.14%vs 67.09%,P<0.001),and the AUC values were also higher(0.808 vs 0.713,P=0.004;0.784 vs 0.713,P=0.007).The NRI for FISH compared to cytology was 21.03%(P=0.003).In the 57 cases of non-invasive UC,the AUC values for all three methods were low(AUC<0.700).Among the 112 cases of high-grade UC,FISH had higher accuracy(84.94%vs 76.45%,P=0.005),and the combination had higher sensitivity(89.29%vs 66.07%,P<0.001)compared to cytology.The AUC values for FISH and the combination were also superior to that for cytology(0.847 vs 0.752,P=0.002;0.827 vs 0.752,P=0.001).The NRI for FISH compared to cytology was 19.01%(P=0.003).In the 24 cases of low-grade UC,the AUC values for all three methods were low(AUC<0.600).Conclusion:For UC,particularly invasive and high-grade subtypes,FISH shows superior diagnostic efficacy compared to cytology.FISH alone offers accuracy and sensitivity comparable to the combination test,with higher specificity.In cases of non-invasive or low-grade UC,however,all three diagnostic methods demonstrate relatively low efficacy.
5.Recent Advances and Controversies in Minute Pulmonary Meningothelial-like Nodules.
Haochen LI ; Jianchao XUE ; Pan LI ; Yuan XU ; Zhibo ZHENG ; Shanqing LI ; Naixin LIANG
Chinese Journal of Lung Cancer 2023;26(8):621-629
Minute pulmonary meningothelial-like nodules (MPMNs) are benign small lesions in the lungs, with similar pathological characteristics to the meningeal epithelium. MPMNs have similar imaging manifestations to malignant tumors, which can lead to misdiagnosis in clinical practice. There is no consensus on the pathogenesis of MPMNs, with some suggest that MPMNs derive from reactive proliferation, while others suggest that MPMNs share a common origin and molecular mechanism with meningiomas in the central nervous system. Understanding the characteristics of MPMNs and studying their pathogenesis will help improve the understanding and diagnosis of MPMNs. In this article, we reviewed the clinical, pathological, imaging characteristics, differential diagnosis and pathogenesis of MPMNs. We also analyze the existing research advances regarding the pathogenesis and propose prospects for further research.
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6.Ten Years Data Analysis of High Impact Papers of Chinese Hospitals
Xue JIANG ; Ruya GUO ; Haochen WANG ; Xiaoying ZHENG
Chinese Journal of Medical Science Research Management 2016;29(3):176-180,184
Academic Papers published with hospital-based data between 2004~2013 on top 5% impact factor journals in all JCR 184 subject categories were reviewed in the study.All of them were differentiated to 3 groups according to the ways of collaboration between authors.The distribution of these papers institutions and subjects were studied and questionnaire survey to hospitals was also used.It's found that the multidisciplinary collaborating work is a key factor to publish high impact papers which showed the central tendency in subjects and institutions levels,active management measures on interdisciplinary development will contribute the outcome of high impact papers.
7.Variables Building on the Quantity Evaluation of the Collaboration Level of Interdisciplinary
Xue JIANG ; Feng ZHOU ; Haochen WANG ; Xiaoying ZHENG
Chinese Journal of Medical Science Research Management 2015;28(2):147-149,153
Interdisciplinary can be acted in any stages of researching procedure.The interdisciplinary process research thinking were addressed including how to builds variables,which are depth and width,fixed discipline or not,and also to reflect the collaboration level of interdisciplinary in certain period.By this quantity evaluation mode building,it will useful for the interdisciplinary research in the future,especially in medical and life science fields.
8.Serum biochemical changes in fighter pilots before and after plateau training
Haochen XUE ; Xiaoquan ZHU ; Hong XUE ; Weidong LI ; Chengxuan XU
Chinese Journal of Aerospace Medicine 2015;26(1):33-37
Objective To evaluate the influence of plateau hypoxia environment on the parameters of liver,renal,cardiac and metabolic functions of fighter pilots,and provide the basis for the high altitude aeromedical service.Methods Serum biochemical indices were examined and compared among 35 fighter pilots before and after 3-month high altitude training by automatic biochemistry analyzer and the results were analyzed by paired t-test.Results Compared with those before plateau training,pilots' fasting serum aspartate aminotransferase (AST),albumin (ALB),blood urea nitrogen (BUN) levels after plateau training were decreased slightly or significantly (t=2.042,10.329,2.275,P<0.05 or <0.01),but were still in the normal range.Direct bilirubin (DBIL),creatinine (Cr),Beta2-microglobuline (β2-MG),lactate dehydrogenase (LDH),creatinine kinase (CK),total cholesterol (TC) were significantly higher than those before the training (t=3.792-12.454,P<0.01),but were basically in the normal range or approaching to upper limits;uric acid (UA) was significantly higher than that before training and the normal (t=4.373,P<0.01);alanine aminotransferase (ALT),total bilirubin (TBIL),total protein (TP),cystatin C (Cys C),glucose (Glu),triglycerides (TG) levels did not change significantly.Conclusions This study elucidated that high altitude environment can affect pilot's partial liver,renal,cardiac and metabolic functions.So the preventive measures should be strengthened.
9.Serum biochemical changes in fighter pilots before and after plateau training
Haochen XUE ; Xiaoquan ZHU ; Hong XUE ; Weidong LI ; Chengxuan XU
Chinese Journal of Aerospace Medicine 2015;26(1):33-37
Objective To evaluate the influence of plateau hypoxia environment on the parameters of liver,renal,cardiac and metabolic functions of fighter pilots,and provide the basis for the high altitude aeromedical service.Methods Serum biochemical indices were examined and compared among 35 fighter pilots before and after 3-month high altitude training by automatic biochemistry analyzer and the results were analyzed by paired t-test.Results Compared with those before plateau training,pilots' fasting serum aspartate aminotransferase (AST),albumin (ALB),blood urea nitrogen (BUN) levels after plateau training were decreased slightly or significantly (t=2.042,10.329,2.275,P<0.05 or <0.01),but were still in the normal range.Direct bilirubin (DBIL),creatinine (Cr),Beta2-microglobuline (β2-MG),lactate dehydrogenase (LDH),creatinine kinase (CK),total cholesterol (TC) were significantly higher than those before the training (t=3.792-12.454,P<0.01),but were basically in the normal range or approaching to upper limits;uric acid (UA) was significantly higher than that before training and the normal (t=4.373,P<0.01);alanine aminotransferase (ALT),total bilirubin (TBIL),total protein (TP),cystatin C (Cys C),glucose (Glu),triglycerides (TG) levels did not change significantly.Conclusions This study elucidated that high altitude environment can affect pilot's partial liver,renal,cardiac and metabolic functions.So the preventive measures should be strengthened.
10.Construction of interdisciplinary in general hospital
Xue JIANG ; Haochen WANG ; Lijun LIANG ; Wen ZHANG ; Ruomu TANG ; Rushan JIANG ; Chun ZHANG
Chinese Journal of Medical Science Research Management 2014;27(1):80-82,85
Analysis is made to the necessary of interdisciplinary,and point four sections should be concerned when begin to construct the interdisciplinary in general hospital which are short term profits and long term culture,personal development and team building,the passion of the young and the leadership of the old,the cooperation with the science and engineering and the communicate with the humanities.At last it also lists the steps and main points on how to begin the construction of interdisciplinary in general hospital.

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